Primary and Secondary Form of Ophthalmia Neonatorum from the View of Chlamydia Trachomatisand Chlamydia (Chlamydophila) Pneumoniae Infections

Overview

The authors are specialized in direct captures of chlamydial newborn infections during screening examinationsin maternity hospital. They focus on symptoms of inflammatory conjunctival reaction and pathological discharge.They had inspected 671 newborns in the Maternity Hospital of Faculty Hospital Královské Vinohrady fromJanuary 2002 till May 2003. Conjunctival scrapings had been done in 29 cases. Chlamydial conjunctivitis wasidentified only in four cases by microbiological examination, Chlamydia trachomatis and Chlamydia pneumoniaetwo cases, respectively. There was a combination of infections of Chlamydia trachomatis and Neisseria gonorrhoeaediagnosed in one patient.Newborns who were negative in chlamydial tests but with signs of ophthalmia neonatorumhad undergone microbiological tests for possibility of other bacterial etiology. Staphylococcus aureus and Escherichiacoli were proved in one case both as a cause of mucopurulent conjunctivitis. Only 0.9% of newbornsnecessitated antibiotic treatment because of positive microbiological finding and simultaneous clinical symptomof mucopurulent conjunctivitis. Newborns who were negative in microbiological tests were followed continuouslyfor persistent secondary conjunctival hyperemia withmucous discharge. Inborn lacrimal obstruction was the causeand this was confirmed at 4.6% of newborns from the followed group. Clarithromycin at the dose 15 mg/kg/perday orally was used in the treatment of chlamydial conjunctivitis for 7 to 10 days. Gonococcal conjunctivitis wastreated parenterally with ceftriaxon 50 mg/kg/per day 7 days. In two cases of bacterial conjunctivitis the authorsused ofloxacin for local treatment for 10 days.

Key words:
conjunctivitis, ophthalmia neonatorum, Chlamydia trachomatis, Chlamydia pneumoniae, obstructionof the lacrimal pathway, antibiotics